title: Predictors of distress in cancer patients and their partners: the role of optimism in the sense of coherence construct.
abstract: OBJECTIVE
  The aim of this study was to clarify the associations between sense of coherence (SOC), dispositional optimism and distress (i.e., anxiety and depression) in cancer patients and their partners.
  
  
  METHODS
  The associations between SOC, dispositional optimism (Life Orientation Test-Revised, LOT-R), depression (Beck Depression Inventory-14, BDI-14) and anxiety (Endler Multidimensional Anxiety Scales, EMAS-State) were studied in 147 cancer couples. The data were collected with self-report questionnaires at the time of diagnosis (2 months) and after 6 months. Path analysis was used to analyse the predictors of follow-up distress and crossover effects in the longitudinal data.
  
  
  RESULTS
  Optimistic patients and patients with strong SOC as well as their partners reported fewer symptoms of depression and anxiety than less optimistic subjects and subjects with weaker SOC. Optimism partially explained the effect of SOC on distress and SOC seemed to be an independent factor in predicting distress. Patient and partner distress at baseline and at 8-month follow-up correlated positively. In addition, high partner optimism at baseline seemed to predict low patient anxiety at follow-up.
  
  
  CONCLUSIONS
  The beneficial effects of SOC seem to include also other elements beyond optimism. In clinical practice, enhancing optimistic expectations of the future and promoting SOC could be expected to reduce distress in cancer patients and their partners.
authors.affiliation: Institute of Behavioural Sciences, University of Helsinki, P.O. Box 9 (Siltavuorenpenger 20 D), 00014 Helsinki, Finland. mila.gustavsson@helsinki.fi
authors.forename: M
authors.initials: M
authors.lastname: Gustavsson-Lilius
authors.forename: J
authors.initials: J
authors.lastname: Julkunen
authors.forename: P
authors.initials: P
authors.lastname: Keskivaara
authors.forename: J
authors.initials: J
authors.lastname: Lipsanen
authors.forename: P
authors.initials: P
authors.lastname: Hietanen
mesh_terms: D000368:Aged; D001294:Attitude to Health; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D060685:Sense of Coherence; D018454:Spouses; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology*; D011795:Surveys and Questionnaires